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A comprehensive systematic literature review of the health-related quality-of-life (HRQOL) differences among individuals with chronic ankle instability (CAI), ankle-sprain copers, and healthy control participants has not been conducted. It could provide a better indication of the self-reported deficits that may be present in individuals with CAI. To systematically summarize the extent to which HRQOL deficits are present in individuals with CAI. We searched for articles in the electronic databases of EBSCO Host and PubMed Central using key words chronic, functional, mechanical, coper, instability, sprains, and patient-assessed. We also performed a hand search of reference lists, authors, and patient-reported outcomes (PROs) of the articles screened for inclusion. Studies were included if they (1) incorporated a PRO as a participant descriptor or as a study outcome to compare adults with CAI to ankle-sprain copers or healthy controls, (2) were written in English, and (3) were published in peer-reviewed journals. Two authors independently assessed methodologic quality using the modified Downs and Black Index. Articles were filtered into 3 categories based on between-groups comparisons: CAI and copers, CAI and healthy control participants, copers and healthy participants. We calculated Hedges g effect sizes and 95% confidence intervals to examine PRO group differences. Of the 124 studies assessed for eligibility, 27 were included. A total of 24 articles compared PROs in individuals with CAI and healthy controls, 7 compared individuals with CAI and copers, and 4 compared copers and healthy controls. Quality scores on the modified Downs and Black Index ranged from 52.9% to 88.2%, with 8 high-, 16 moderate-, and 3 low-quality studies. Overall, we observed moderate to strong evidence that individuals with CAI displayed deficits on generic and region-specific PROs compared with copers and healthy controls. However, evidence that differences exist between copers and healthy controls was conflicting. In addition, for dimension-specific outcomes, evidence to suggest that fear of reinjury is heightened in individuals with CAI was limited. The evidence suggested that CAI is associated with functional and HRQOL deficits, particularly when examined with region-specific PROs. However, PROs do not appear to differ between copers and healthy controls.

Individuals with chronic ankle instability (CAI) experience disease- and patient-oriented impairments that contribute to both immediate and long-term health detriments. Investigators have demonstrated the ability of targeted interventions to improve these impairments. However, the combined effects of a multimodal intervention on a multidimensional profile of health have not been evaluated. To examine the effects of a 4-week rehabilitation program on disease- and patient-oriented impairments associated with CAI. Controlled laboratory study. Laboratory. Twenty adults (5 males, 15 females; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, mass = 70.58 ± 12.90 kg) with self-reported CAI participated. Inclusion criteria were at least 1 previous ankle sprain, at least 2 episodes of \"giving way\" in the 3 months before the study, and a Cumberland Ankle Instability Tool score ≤24. Individuals participated in 12 sessions over 4 weeks that consisted of ankle stretching and strengthening, balance training, and joint mobilizations. They also completed home ankle-strengthening and -stretching exercises daily. Dorsiflexion range of motion (weight-bearing-lunge test), isometric ankle strength (inversion, eversion, dorsiflexion, plantar flexion), isometric hip strength (abduction, adduction, flexion, extension), dynamic postural control (Y-Balance test), static postural control (eyes-open and -closed time to boundary in the anterior-posterior and medial-lateral directions), and patient-reported outcomes (Foot and Ankle Ability Measure-Activities of Daily Living and Foot and Ankle Ability Measure-Sport, modified Disablement in the Physically Active scale physical and mental summary components, and Fear-Avoidance Beliefs Questionnaire-Physical Activity and Fear-Avoidance Beliefs Questionnaire-Work) were assessed at 4 times (baseline, preintervention, postintervention, 2-week follow-up). Dorsiflexion range of motion, each direction of the Y-Balance test, 4-way ankle strength, hip-adduction and -extension strength, the Foot and Ankle Ability Measure-Activities of Daily Living score, the modified Disablement in the Physically Active scale-physical summary component score, and the Fear-Avoidance Beliefs Questionnaire-Physical Activity score were improved at postintervention ( < .001; effect-size range = 0.72-1.73) and at the 2-week follow-up ( < .001; effect-size range = 0.73-1.72) compared with preintervention. Hip-flexion strength was improved at postintervention compared with preintervention ( = .03; effect size = 0.61). Hip-abduction strength was improved at the 2-week follow-up compared with preintervention ( = .001; effect size = 0.96). Time to boundary in the anterior-posterior direction was increased at the 2-week follow-up compared with preintervention ( < .04; effect-size range = 0.61-0.78) and postintervention ( < .04) during the eyes-open condition. A 4-week rehabilitation program improved a multidimensional profile of health in participants with CAI.

Extreme flooding impacts millions of people that live within the Amazon floodplain. Global hydrological models (GHMs) are frequently used to assess and inform the management of flood risk, but knowledge on the skill of available models is required to inform their use and development. This paper presents an intercomparison of eight different GHMs freely available from collaborators of the Global Flood Partnership (GFP) for simulating floods in the Amazon basin. To gain insight into the strengths and shortcomings of each model, we assess their ability to reproduce daily and annual peak river flows against gauged observations at 75 hydrological stations over a 19-year period (1997–2015). As well as highlighting regional variability in the accuracy of simulated streamflow, these results indicate that (a) the meteorological input is the dominant control on the accuracy of both daily and annual maximum river flows, and (b) groundwater and routing calibration of Lisflood based on daily river flows has no impact on the ability to simulate flood peaks for the chosen river basin. These findings have important relevance for applications of large-scale hydrological models, including analysis of the impact of climate variability, assessment of the influence of long-term changes such as land-use and anthropogenic climate change, the assessment of flood likelihood, and for flood forecasting systems.

To conduct a systematic review with meta-analysis assessing the effectiveness of conservative rehabilitation programs for improving health-related quality of life (HRQL) in individuals with chronic ankle instability (CAI).   PubMed, MEDLINE, CINAHL, and SPORTDiscus were searched from inception to January 2016.   Studies were included if the researchers examined the effects of a conservative rehabilitation protocol in individuals with CAI, used validated patient-reported outcomes (PROs) to quantify participant-perceived HRQL, and provided adequate data to calculate the effect sizes (ESs) and 95% confidence intervals (CIs). Studies were excluded if the authors evaluated surgical interventions, prophylactic taping, or bracing applications or examined only the immediate effects of 1 treatment session.   Two investigators independently assessed methodologic quality using the Physiotherapy Evidence Database (PEDro) Scale. Studies were considered low quality if fewer than 60% of the criteria were met. Level of evidence was assessed using the Strength of Recommendation Taxonomy. Preintervention and postintervention sample sizes, means, and standard deviations of PROs were extracted.   A total of 15 studies provided 24 participant groups that were included in the analysis. Seven high-quality studies with a median PEDro score of 50% (range = 10%-80%) and a median level of evidence of 2 (range = 1-2) were identified. The magnitudes of preintervention to postintervention PRO differences were examined using bias-corrected Hedges g ESs. Random-effects meta-analysis was performed to synthesize PRO changes across all participant groups. Positive ES values indicated better PRO scores at postintervention than at preintervention. The α level was set at .05. Meta-analysis revealed a strong ES with a nonoverlapping 95% CI (ES = 1.20, CI = 0.80, 1.60; P < .001), indicating HRQL improved after conservative rehabilitation.   Based on the quality of the evidence and the results of the meta-analysis, grade A evidence showed that conservative rehabilitation produces large improvements in HRQL for people with CAI.

Context: Assessment of health-related quality of life (HRQOL) after injury is important. Differences in HRQOL between nonathletes and athletes and between injured and uninjured athletes have been demonstrated; however, the evidence has not been synthesized. Objective: To answer the following questions: (1) Does HRQOL differ among adolescent and collegiate athletes and nonathletes? (2) Does HRQOL differ between injured adolescent and collegiate athletes or between athletes with a history of injury and uninjured athletes or those without a history of injury? Data Sources: We systematically searched CINAHL, MEDLINE, SPORTDiscus, and PubMed. A hand search of references was also conducted. Study Selection: Studies were included if they used generic instruments to compare HRQOL outcomes between athletes and nonathletes and between uninjured and injured athletes. Studies were excluded if they did not use a generic instrument, pertained to instrument development, or included retired athletes or athletes with a chronic disease. Data Extraction: We assessed study quality using the modified Downs and Black Index Tool. Bias-corrected Hedges g effect sizes and 95% confidence intervals (CIs) were calculated. The Strength of Recommendation Taxonomy (SORT) was used to determine the overall strength of the recommendation. A random-effects meta-analysis was performed for all studies using the composite or total score. Data Synthesis: Eight studies with modified Downs and Black scores ranging from 70.6% to 88.4% were included. For question 1, the overall random-effects meta-analysis was weak (effect size = 0.27, 95% confidence interval = 0.14, 0.40; P < .001). For question 2, the overall random-effects meta-analysis was moderate (effect size = 0.68, 95% confidence interval = 0.42, 0.95; P < .001). Conclusions: Grade A evidence indicates that athletes reported better HRQOL than nonathletes and that uninjured athletes reported better HRQOL than injured athletes. However, the overall effect for question 1 was weak, suggesting that the differences between athletes and nonathletes may not be clinically meaningful. Clinicians should monitor HRQOL after injury to ensure that all dimensions of health are appropriately treated.

In recent years, a range of global flood models (GFMs) were developed, each utilizing different process descriptions as well as validation data sets and methods. To quantify the magnitude of these differences, studies assessed the performance of GFMs only on the continental and catchment level. Since the default model set-ups resulted in locally marked deviations, there is a clear need for further and especially more standardized research to not only maintain credibility, but also support the application of GFM products by end-users. Consequently, here we conceptually outline the basic requirements and challenges of a Global Flood Model Validation Framework for more standardized model validation and benchmarking. With the proposed framework we hope to encourage the much needed debate, research developments in this direction, and involvement of science with end-users. By means of the framework, it is possible to streamline the data sets used for input and validation as well as the validation approach itself. By subjecting GFMs to more thorough and standardized methods, we think their quality as well as acceptance will increase as a result, especially amongst end-users of their outputs. Otherwise GFMs may only serve a purely scientific purpose of continued 'siloed' model improvement but without practical use. Furthermore, we want to invite GFM developers to make their models more integratable which would allow for representation of more physical processes and even more detailed comparison on a model component basis. We think this is pivotal to not only improve the accuracy of model input data sets, but to focus on the core of each model, the process descriptions. Only if we know more about why GFMs deviate, are we able to improve them accordingly and develop a next generation of models, not only providing first-order estimates of flood extent but supporting the global disaster risk reduction community with more accurate and actionable information.

We present PCR-GLOBWB 2, a global hydrology and water resources model. Compared to previous versions of PCR-GLOBWB, this version fully integrates water use. Sector-specific water demand, groundwater and surface water withdrawal, water consumption, and return flows are dynamically calculated at every time step and interact directly with the simulated hydrology. PCR-GLOBWB 2 has been fully rewritten in Python and PCRaster Python and has a modular structure, allowing easier replacement, maintenance, and development of model components. PCR-GLOBWB 2 has been implemented at 5 arcmin resolution, but a version parameterized at 30 arcmin resolution is also available. Both versions are available as open-source codes on https://github.com/UU-Hydro/PCR-GLOBWB_model (Sutanudjaja et al., 2017a). PCR-GLOBWB 2 has its own routines for groundwater dynamics and surface water routing. These relatively simple routines can alternatively be replaced by dynamically coupling PCR-GLOBWB 2 to a global two-layer groundwater model and 1-D–2-D hydrodynamic models. Here, we describe the main components of the model, compare results of the 30 and 5 arcmin versions, and evaluate their model performance using Global Runoff Data Centre discharge data. Results show that model performance of the 5 arcmin version is notably better than that of the 30 arcmin version. Furthermore, we compare simulated time series of total water storage (TWS) of the 5 arcmin model with those observed with GRACE, showing similar negative trends in areas of prevalent groundwater depletion. Also, we find that simulated total water withdrawal matches reasonably well with reported water withdrawal from AQUASTAT, while water withdrawal by source and sector provide mixed results.

To synthesize the literature and perform a meta-analysis for both the interrater and intrarater reliability of the FMS™. Academic Search Complete, CINAHL, Medline and SportsDiscus databases were systematically searched from inception to March 2015. Studies were included if the primary purpose was to determine the interrater or intrarater reliability of the FMS™, assessed and scored all 7-items using the standard scoring criteria, provided a composite score and employed intraclass correlation coefficients (ICCs). Studies were excluded if reliability was not the primary aim, participants were injured at data collection, or a modified FMS™ or scoring system was utilized. Seven papers were included; 6 assessing interrater and 6 assessing intrarater reliability. There was moderate evidence in good interrater reliability with a summary ICC of 0.843 (95% CI = 0.640, 0.936; Q7 = 84.915, p < 0.0001). There was moderate evidence in good intrarater reliability with a summary ICC of 0.869 (95% CI = 0.785, 0.921; Q12 = 60.763, p < 0.0001). There was moderate evidence for both forms of reliability. The sensitivity assessments revealed this interpretation is stable and not influenced by any one study. Overall, the FMS™ is a reliable tool for clinical practice. •Synthesizing the rater reliability of the FMS™ is critical for clinical use.•There is moderate evidence that there is good interrater reliability.•There is moderate evidence that there is good intrarater reliability.

The accurate evaluation of self-reported changes in function throughout the rehabilitation process is important for determining patient progression. Currently, how a response shift (RS) may affect the accuracy of self-reported functional assessment in a population with chronic ankle instability (CAI) is unknown. To examine the RS in individuals with CAI after a 4-week multimodal rehabilitation program. Controlled laboratory study. Laboratory. Twenty adults (5 men, 15 women; age = 24.35 ± 6.95 years, height = 169.29 ± 10.10 cm, mass = 70.58 ± 12.90 kg) with self-reported CAI participated. Inclusion criteria were at least 1 previous ankle sprain, at least 2 episodes of the ankle \"giving way\" in the 3 months before the study, and a score ≤24 on the Cumberland Ankle Instability Tool. Individuals participated in 12 intervention sessions over 4 weeks and daily home ankle strengthening and stretching. Patient-reported outcomes (PROs) were assessed at 4 times (baseline, preintervention, postintervention, and 2-week follow-up). At the postintervention and 2-week follow-up, participants completed then-test assessments to measure RS. Then-test assessments are retrospective evaluations of perceived baseline function completed after an intervention. The PROs consisted of the Foot and Ankle Ability Measure-Activities of Daily Living and Sport subscales, the modified Disablement in the Physically Active scale physical and mental summary components, and the Fear-Avoidance Beliefs Questionnaire Physical Activity and Work subscales. We used repeated-measures analyses of variance to compare preintervention with then-test measurements. Individual-level RSs were examined by determining the number of participants who experienced preintervention to then-test differences that exceeded the calculated minimal detectable change. We did not identify an RS for any PRO ( > 2.338, > .12), indicating no group-level differences between the preintervention and retrospective then-test assessments. Individual-level RS was most prominent in the Foot and Ankle Ability Measure-Sport subscale (n = 6, 30%) and the Fear-Avoidance Beliefs Questionnaire Physical Activity subscale (n = 9, 45%). No group-level RS was identified for any PRO after a 4-week multimodal rehabilitation program in individuals with CAI. This finding indicates that traditional assessment of self-reported function was accurate for evaluating the short-term effects of rehabilitation in those with CAI. Low levels of individual-level RS were identified.

Asciminib, an agent that targets the myristoyl pocket of BCR::ABL, was compared with imatinib and with imatinib plus second-generation tyrosine kinase inhibitors. Outcomes were better with asciminib in both comparisons.